What has changed and what has stayed the same in the past ten years across the healthcare landscape in Canada?
Canada is a mixed market where some patients have private coverage provided by their employer, while others rely on government funding. This setup varies by province and as a result there are disparities in access to medicines across provinces. More than twenty years ago, getting access to a medication was much less contentious and it was a matter of "when", not "if". Canada’s track record for funding new medicines keeps decreasing over time due to the budget restraints that continue to impact the government quite heavily.
There is an increasing number of niche medicines which are very capital intensive to bring to market in terms of R&D, clinical trials and regulatory processes, but the patients that will be using them are much fewer, this has an impact on the price.
Additionally, the medical system suffers from long wait times in ER’s and access to care, but it is difficult for the population to make the link between access to medicine and these long waiting times. The truth is that some drugs help keep patients out of hospitals.
A more streamlined drug delivery system would alleviate some of the ER issues that we are battling in Canada.
In which context did Otsuka enter the Canadian market and what are some of the present drugs that you are working on?
Otsuka entered the Canadian space through a partnership which allowed them to join Bristol Myers Squibb in bringing Abilify to the market. Abilify was an Otsuka discovery, licensed to BMS in Canada. In 2010, we solidified our presence here so as to be able to launch innovations by ourselves to serve the Canadian patients. We have continued to launch products including our own and some new partnerships as well.Today, we recently launched Tavneos and Korsuva that were acquired through a local license. We obtained the rights to Tavneos through a partnership with a Swiss company called Vifor. It is a medicine for ANCA – associated vasculitis (AAV) and it allows patients to be treated and reduce steroid use – which is associated with a lot of negative outcomes.
How does the supply chain work from manufacturing to client and did you encounter any challenges across all these steps, especially during the pandemic?
We generally buy bulk drugs (pills, vials, etc.) and have all the secondary packaging done locally with the help of local suppliers having the right licenses. Once we have the finished packaged goods, we send them to warehouses from where they are distributed directly to wholesalers and then to pharmacies and hospitals. This whole process is meant to offer a more straightforward access to the patient. Every step of drug production can pose challenges. Even the cellophane piece used in manufacturing drugs is being produced in spaces that are inspected regularly, so we cannot simply switch a manufacture overnight. This specific aspect adds an extra layer of complexity even for the non-pharmaceutical pieces of our packaging. Thankfully, Health Canada proved to be quite flexible and accommodating, always putting patients first. We have experienced working with them making it through shortages and protecting patients in various situations.
The beginning of the pandemic brought me more learnings about supply chains than I had in the last 20 years.
Since most of our drugs come to Canada in commuter flights, we suffered from the restrictions imposed in those early days. As a result, we now increased our safety stocks, so we have a solid runway in case things go awry again. The supply chain challenge showed us that we need to have multiple sources for components and always remain agile when juggling them.
The government seems to be getting increasingly interested in life sciences, how do you perceive this shift of perspective?
The efforts the government is making are very positive, but one area where I would like to see a more hands-on deck approach is access to medication. Pharma companies don’t all need government grants to invest in infrastructure but we all need to deliver medicines to patients. By improving in this area, the market will become more attractive in the eyes of international companies since they could potentially have a new place to sell their medicines.
Canadian inflation has been hovering between 5% and 7% for the last period, in a context where pharmaceuticals cannot take price increases. Most of the drugs funded by the Government are subsidized through contracts which freeze prices. As a result, every time we launch a new medicine, we must anticipate the dose of uncertainty that comes with it.
What excites you the most about the job that you do at Otsuka?
I am curious by nature, and I am interested in how to make things better by understanding the innovation, research and ease of delivery of medicines to help patients with specific diseases. We are extremely patient centric at Otsuka and since there is no shortage of challenges, I feel extremely driven and motivated to take action each and every day. We are looking at things from the perspective of a patient or a caregiver and everyone who works at the company needs to understand how they impact the patient because all these little efficiencies can affect the outcome for patients in a highly positive way.
